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Alcohol, Family Problems and Work

Many families face a host of difficulties closely associated with problem drinking, and these problems quite often spill into the workplace. By encouraging treatment for problem drinking, employers can contribute to improvement in other, co-occurring illnesses, including depression; and ease violence and injury due to suicide, domestic abuse and accidents

Alcohol Problems and Other Mental Illnesses

Many working people who have serious drinking problems also suffer from mental illnesses such as depression. When these two health problems exist simultaneously, a person is said to have co-occurring disorders. More than a third of adults with alcohol problems also have depression.1 Phobias and post-traumatic stress disorders also commonly co-occur with alcohol problems.2 When the illnesses occur at the same time, the symptoms become more severe, more disruptive to everyday life and more complicated to treat.3 4 People with co-occurring alcohol problems and mental illnesses are more frequently hospitalized, require longer hospital stays and have poorer outcomes.5 As employers look to their health plans and disease management programs to help manage the care of employees and their families with chronic illnesses, it is important that the frequent co-occurrence of alcohol problems be addressed.


Many businesses recognize that treating depression can yield substantial benefits in reduced absenteeism. Such treatment can lower the costs of short- and long-term disability and workers’ compensation.6 Depressed workers miss an average of 19.2 workdays each year.7 Depression reduces at-work productivity, according to national survey data, by 3.3 to 5.3 hours/week.8 Experts estimate the cost to businesses for each depressed worker at $600 annually, with two-thirds of these costs related to absenteeism and lost productivity.9 Depressed employees also have a greater number of injuries on the job. A large body of research shows that high quality treatment of depression can reduce days of work missed and cut low productivity days.10

For one-third of depressed workers with a co-occurring alcohol use disorder, treatment of the depression with medication alone has little or no effect on problem drinking.11 The combination of antidepressant medications and a type of psychotherapy called cognitive behavioral therapy may reduce both depression and substance use.12

As business leaders seek ways to improve the care of their employees with chronic illnesses such as depression, it is important that they keep in mind the frequent co-occurrence of alcohol problems with these disorders. Health plans, disease management programs and Employee Assistance Programs should screen for and treat these co-occurring illnesses.

Suicide and Alcohol

Suicide is the eleventh leading cause of death in the U.S. About one in five of these victims had alcoholism.13 14 Suicide rates for people with alcoholism are 30 times greater than for the general population.15

People with the co-occurring alcohol use disorders and depression are at high risk of suicide,16 because alcohol use can increase impulsivity at the same time that depression reduces feelings of self-worth and optimism about the future.17 18

As nearly two-thirds of all suicides, almost 20,000 deaths each year, occur among 26- to 65-year-old adults, people who make up the core of the U.S. labor force, businesses can help reduce risks of employee and employee family suicide. Effective Employee Assistance Programs (EAPs) and health insurance programs can increase screening and treatment for alcohol problems and depression.

Domestic Abuse

Domestic violence costs businesses more than $3 billion annually from increased health care costs, lost productivity, increased absenteeism and employee turnover.19 And violence in the home – one of the nation’s most pervasive forms of criminal activity, affecting between two and four million women and children each year20 – is closely linked to drinking. Sixty percent of batterers are drinking when they are beating their partner.21 The repercussions of alcohol-related domestic violence reverberate far beyond the home.

Batterers sometimes subject victims and their coworkers to violence in the workplace. Seventy-four percent of employed battered women are harassed by their abusive partners at work by phone or in person. Between 1993 and 1999, an average of 1.7 million domestic victimizations of people 12 and older occurred at work.22

Domestic violence affects businesses through increased health care costs and reduced productivity. Researchers believe that treatment of injuries caused by family violence cost $857 million in 1997.23 Over 7.9 million paid workdays are lost each year to domestic violence, costing American businesses an estimated $727.8 million.24 Fifty-six percent of women abused by their partners are late at least five times a month, 28 percent leave work early five times a month, 54 percent miss at least three full days each month.25 Each year, about one woman in five subjected to domestic violence quits or loses her job.26

The personal trauma and the business costs of domestic abuse could be reduced if alcohol problems were more readily recognized and treated. Batterers are three times more likely than nonbatterers to be problem drinkers.27 Which comes first, serious alcohol problems or serious domestic conflicts, has not been settled by researchers. However, what is not ambiguous is that the more alcohol a batterer drinks, the greater the severity of a given incident.28

Businesses, through their Employee Assistance Programs and health insurance programs, can help break the cycle of violence and alcohol use.

Problem Drinking Increases Risk of Injury

Young people face a higher likelihood of dying from accidents than from any other single cause, with alcohol consumption substantially increasing the likelihood of injury or death. Alcohol use is closely linked to car crash injuries, falls, assaults, burnings and drownings.29 Drinking accounts for as much as one-third of all accidental deaths.30 Participation in the workforce does not make people immune to alcohol-related accidents and injuries, which can occur when workers drink heavily off the job, or drink before or during work hours.31

One study found that workers with alcohol problems were 2.7 times more likely than workers without drinking problems to have injury-related absences.32 A hospital emergency department study showed that 35 percent of patients with an occupational injury were at-risk drinkers.33 Breathalyzer tests in another study detected alcohol in 16 percent of emergency room patients injured at work.34 Analyses of workplace fatalities showed that at least 11 percent of the victims had been drinking.35

Large federal surveys show that 24 percent of workers report drinking during the workday least once in the past year.36 Drinking outside work hours can cause problems on the job. Employees may show up to work hung over.37 One-fifth of workers and managers across a wide range of industries and company sizes report that a coworker’s on- or off-the-job drinking jeopardized their own productivity and safety.38

Employers can increase workplace safety by improving employees’ access to treatment for alcohol problems and through other actions. For more information, see Seven Tools to Lower the Business Costs of Alcohol Problems.


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